Iron Formulations for the Treatment of Iron Deficiency Anemia in Patients with Inflammatory Bowel Disease: A Cost-Effectiveness Analysis in Switzerland

Aksan, A; Schoepfer, Alain; Juillerat, Pascal; Vavricka, Stephan R.; Bettencourt, Miguel; Arellano, Antonio Ramírez de; Gavata, Simona; Morin, N.; Valentine, William J.; Hunt, Barnaby

doi:10.1007/s12325-020-01553-1

Cited by 17 publications

(13 citation statements)

References 41 publications

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“…The occurrence of anemia ranges from 9-73% in outpatients and 32-74% upon admission [9,10,13]. The prevalence of iron deficiency in IBD-associated anemia is estimated at around 36-90% [14,15]. According to Woźniak et al, iron deficiency in newly diagnosed IBD patients is as high as 77.53% [6].…”

Section: Idamentioning

confidence: 99%

Iron Deficiency Anemia in Inflammatory Bowel Diseases—A Narrative Review

et al. 2021

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Inflammatory bowel disease (IBD), which includes Crohn’s disease and ulcerative colitis, is characterized by chronic inflammation of the gastrointestinal tract. IBD has been associated with numerous symptoms and complications, with the most common being iron deficiency anemia (IDA). Iron deficiency in IBD is caused by inadequate intake, malabsorption (including duodenal involvement and surgical removal), and chronic blood loss by mucosal ulcerations. Therefore, an appropriate diet should be enforced. Iron deficiency and iron supplementation have been associated with alterations to gut microbiota. IBD-associated anemia, in particular iron deficiency anemia, is associated with a significant decrease in quality of life and with clinical symptoms such as chronic fatigue, headaches and dizziness, reduced exercise tolerance, pale skin, nails, conjunctiva, and fainting. However, despite these numerous adverse symptoms, IDA remains undertreated. The European Crohn’s and Colitis Organisation (ECCO) guidelines state that patients should be monitored for anemia. Adequate treatment, whether oral or intravenous, should be implemented while taking into consideration C-reactive protein values (CRP), hemoglobin levels, and therapeutic response. It should be stressed that every case of anemia in IBD patients should be treated. Intravenous iron formulations, which are more superior compared to the oral form, should be used. There is a need to increase awareness and implementation of international guidelines on iron supplementation in patients with IBD.

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Section: Idamentioning

confidence: 99%

Iron Deficiency Anemia in Inflammatory Bowel Diseases—A Narrative Review

et al. 2021

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“…However, IV iron is significantly more costly, being over 60 times more expensive than oral iron [16]. Despite this, cost-effectiveness analysis for the treatment of IDA in IBD patients identified ferric carboxymaltose as the most cost-effective treatment due to suitable adherence to treatment, the high number of patients that respond to the treatment, improvements in hospitalisation rates, and patient quality of life [17].…”

Section: Introductionmentioning

confidence: 99%

Oral Iron Supplementation—Gastrointestinal Side Effects and the Impact on the Gut Microbiota

Bloor

Schutte

Hobson

2021

Microbiology Research

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Iron deficiency anaemia (IDA) is a worldwide healthcare problem affecting approximately 25% of the global population. The most common IDA treatment is oral iron supplementation, which has been associated with gastrointestinal (GI) side effects such as constipation and bloating. These can result in treatment non-adherence and the persistence of IDA. Intravenous iron does not cause GI side effects, which may be due to the lack of exposure to the intestinal lumen. Luminal iron can cause changes to the gut microbiota, aiding the promotion of pathogenic species and decreasing beneficial protective species. Iron is vital for methanogenic archaea, which rely on iron for growth and metabolism. Increased intestinal methane has been associated with slowing of intestinal transit, constipation, and bloating. Here we explore the literature to understand a potential link between iron and methanogenesis as a novel way to understand the mechanism of oral iron supplementation induced GI side effects.

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“…A CEA of FD vs. FCM in the UK found that haematological response was 9% higher in patients treated with FD than with FCM [24]. On the other hand, two separate analyses of FCM vs. FD and IS in Switzerland and the UK estimated that, in terms of costeffectiveness, FCM was both more effective and less costly for the respective health-care systems [25,26]. In the Nordic context, a 2018 economic evaluation of FD vs. FCM was conducted in the Danish setting, followed by another economic evaluation in 2021, which used data for patients in Norway, Sweden, and Denmark.…”

Section: Introductionmentioning

confidence: 99%

Cost-Effectiveness of Intravenous Iron Formulations in Patients with Iron Deficiency Anaemia and Inflammatory Bowel Disease, in a Swedish Regional Setting Using Real-World Tender Prices

et al. 2022

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Aims. A widespread complication of inflammatory bowel disease (IBD) is iron deficiency anaemia (IDA), which affects quality of life (QoL) and is associated with frequent hospitalizations. The intravenous iron therapies, ferric carboxymaltose (FCM), ferric derisomaltose (FD), and iron sucrose (IS), have previously been shown to replenish haemoglobin (Hb) levels more effectively than oral iron. However, they differ in both costs and efficacy (response to treatment), leading to differences in acquisition by health-care payers. We investigated the cost-effectiveness of FCM versus FD and IS, in terms of additional cost per additional responder, for the treatment of IBD-associated IDA in multiple Swedish regional settings, using current tender prices. Methods and Materials. A microsimulation model estimated the additional cost per patient achieving a response, based on Hb normalization or an increase of ≥2 g/dL in Hb levels. Efficacy estimates were taken from a previously published network meta-analysis. Treatment costs (2021 SEK) included current tender prices in Swedish health-care regions. Resource use depended partly on dosing, which was based on patient characteristics simulated in the model. Results. The analysis showed that FCM was associated with the highest number of responders (81%) compared to FD (74%) and IS (75%), while costing less per responder than its comparators, in included regions. Conclusions. These results suggest that regional health-care budget holders should consider more than drug prices when choosing which IV formulations to acquire and that they should use all available tools when deciding how to fulfil the needs of their patients.

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Iron Formulations for the Treatment of Iron Deficiency Anemia in Patients with Inflammatory Bowel Disease: A Cost-Effectiveness Analysis in Switzerland

Abstract: Introduction: Iron deficiency anemia (IDA) is a common complication of inflammatory bowel disease (IBD) and can result in reduced quality of life and increased healthcare costs. IDA is treated with iron supplementation, either with

Cited by 17 publications

References 41 publications

Iron Deficiency Anemia in Inflammatory Bowel Diseases—A Narrative Review

Iron Deficiency Anemia in Inflammatory Bowel Diseases—A Narrative Review

Oral Iron Supplementation—Gastrointestinal Side Effects and the Impact on the Gut Microbiota

Cost-Effectiveness of Intravenous Iron Formulations in Patients with Iron Deficiency Anaemia and Inflammatory Bowel Disease, in a Swedish Regional Setting Using Real-World Tender Prices

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